Central nervous system metastases (CNSm) in patients with colorectal cancer (CRC): A retrospective review.

Abstract

e14105 Background: CNSm are infrequent events in patients (pts) with CRC and only a few number of retrospective and small studies have been published in this setting. We present the results of a retrospective analysis focused on this topic. Methods: Between 1991 and 2009, clinical records from 3551 CRC pts treated at our institution were analysed: 2103 pts developed systemic metastases and 44 pts (1.2 %) developed CNSm. Results: Median age of CNSm pts was 66 years (range 23-80) and 33 pts were males (70%). Primary location: colon 27 pts (61%), rectum 17 pts (39%). ECOG: 0-1: 23 pts, 2: 13 pts, 3: 6 pts. CNS was the only metastatic site in 11 pts (25%) and in the remaining 33 pts there were also lung (22 pts), liver (20 pts), bone (6 pts) or distant lymph node (6 pts) metastases. Twelve pts (27%) presented CNSm at diagnosis of CRC and 32 pts (73%) developed CNSm after a median of 23 months (range 2-107). In 18 pts (41%) there was only one CNSm; the more frequently involved locations were the parietal lobe (8 pts, 18%) and the cerebellum (5 pts, 11%). Eleven pts (25%) suffered neurologic deficits, 8 pts (18%) seizures, 5 pts (11%) headache and 5 pts behaviour disorders. Treatment after CNSm diagnosis: 22 pts (50%) received only best supportive care, 14 pts (32%) were treated with radiotherapy, 3 pts (7%) with surgery, 2 pts (4%) with radio- surgery, 1 patient (2%) with surgery plus radiotherapy and only 1 patient was treated with chemotherapy (5FU-oxaliplatin). Three pts (7%) treated with surgery were rendered disease free and two of these pts (4%) remained alive and disease free after a follow up of 18.7 and 17.8 months. The other 42 pts have died with progressive disease and median overall survival was 2 months. Conclusions: CNSm are infrequent events in CRC pts. The prognosis of these pts is poor and their treatment remains a challenge. No significant financial relationships to disclose.